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Transcranial magnetic stimulation in patients with transient ischemic attacks
Wen-Jang Wong1, Jen-Tse Chen, Chuen-Der Kao
1Neurological Institute, Taipei Veterans General Hospital, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|September 11, 2004
Summary
Transient ischemic attacks (TIAs) may cause lasting subclinical motor deficits if symptoms persist over one hour. Full recovery is likely if motor symptoms resolve within one hour following a TIA.
Area of Science:
- Neuroscience
- Neurology
- Neurophysiology
Background:
- Transient ischemic attacks (TIAs) are defined by symptom resolution within 24 hours.
- Some TIAs result in persistent perfusion defects or infarction.
- Subclinical dysfunction after TIA requires further investigation.
Purpose of the Study:
- To investigate persistent subclinical motor dysfunction after TIA using transcranial magnetic stimulation (TMS).
- To determine if TIA duration influences the persistence of motor deficits.
Main Methods:
- 23 TIA patients with hand weakness underwent TMS twice: 24-48 hours and 7 days post-onset.
- Assessed cortical motor threshold, motor evoked potentials, central motor conduction time, and cortical silent period.
- Recordings were taken from the first dorsal interosseous muscle.
Main Results:
- No significant differences were found in the overall TIA group compared to controls.
- TIA patients with hand weakness >1 hour showed increased motor threshold and prolonged cortical silent period initially.
- These deficits improved within one week in the >1 hour subgroup.
- TIA patients with hand weakness <1 hour exhibited normal TMS findings.
Conclusions:
- Motor function assessed by TMS recovers fully if TIA-related motor symptoms resolve within 1 hour.
- Subclinical motor deficits may persist beyond 24 hours in TIA patients with prolonged motor symptoms (>1 hour).